Its been said ones reach should exceed one's grasp, which explains why there's been so much talk about regional health information organizations, or RHIOs, as nearly everyone in proximity of the Healthcare Information Management and Systems Society meeting here knows to call them. By day two of the show that included a majority of the members of the Ernest Morial Convention Center custodial staff, nearly half of New Orleans cab drivers and 13.5% of licensed Mississippi River excursion boat pilots did as well.
And while there have been far more sightings of Big Foot than verified reports of live, operating RHIOs, many here, particularly among the ranks of HIMSS presenters, believe theyll live to see the latter before they have a picnic in the woods visited by the former.
Stephanie Mills is a physician-informaticist, which by double-definition means she is a woman of science, but that does not preclude her from being a believer of things yet unseen. Mills, is the chief medical information officer at 986-bed Our Lady of the Lake Regional Medical Center in Baton Rouge, La., and has been working on developing RHIOs in both Baton Rouge and New Orleans. As if that werent visionary enough, Mills told a reporter she hopes to one day link those two RHIOs together and expand data exchange coverage across the entire state. So far, however, while planning is being funded by HHS as part of the Hurricane Katrina recovery effort, RHIOs in both cities remain RHIOs in theory, not RHIOs in fact.
Like Mills, Dick Gibson is a physician-informaticist. He is chief medical information officer, regional information services, at Providence Health & Services in the Pacific Northwest. And even though Gibson lives in the land of sasquatch, during a panel discussion this week he injected some sobering findings of his RHIO study group into the discussion.
Gibson is helping plan a RHIO in Oregon, which is being sponsored by Providence and several other large healthcare systems and payers that have thus far plunked down $540,000 in two rounds of development funding.
As he sees it, here are some of the problems:
- Money. "It is extraordinarily expensive, Gibson said, with eight to 10 participating hospitals expected to pony up $17 million over five years, or an estimated $10 per patient, versus the projected benefits of $2.5 million a year in cost savings.
- Privacy. Plans call for using a centralized record locator service, and payers want access to the clinical data. "Im worried the public wont allow it."
- Doctors. RHIO planners are calling for a Web-based viewer that will enable clinicians to look up patient records generated at another hospital. It is hard enough to get physicians to use IT systems within their own hospital, Gibson said, and will be harder still to get them to look up and retrieve records from another system, even if it only means toggling from one screen to another. "Im worried its too great of a load for too little of a benefit. The interoperability will be a big leap forward for emergency room physicians and for disease management purposes, Gibson said, but for rank-and-file physicians seeing most patients, the utility will be marginal.
"I cant predict the future," Gibson said, but added that what he sees looming is "a perfect vacuum" of difficulties that could suck the life out of the effort. A final report on the RHIO plan is due June 5.What do you think? Write us with your comments at [email protected]. Please include your name, title and hometown.